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Simple Summary: Fungal diseases, despite their low incidence in fish, appear to be lethal in many teleost and elasmobranch species. There are many fungi involved, including Paecilomyces spp., Exophiala spp. and Fusarium spp., among the most frequently diagnosed. Fungal diseases in elasmobranchs have been documented in animals under human care in aquariums since 1980. Most cases have resulted in high mortality due to a lack of information concerning the treatment and medical and environmental management of mycoses in these species. Antifungal drugs are frequently prescribed to improve clinical signs or lesions in animals affected by fungal infections. Azole agents appear to be the most effective antifungals in the treatment of systemic fungal infections. However, more evidence concerning the use of these drugs in elasmobranchs is needed. Introduction: Elasmobranchs currently constitute an important part of the animal collection of many aquariums worldwide. Their maintenance under human care has allowed us to describe and identify new pathogens and diseases affecting them, as well as to determine different treatments for these diseases. Great advances in elasmobranch husbandry have been developed. Methods: A search was performed on scientific databases as PubMed and other specialized sources (IAAAM archive). Results: Little information on pharmacotherapeutics is available in this taxonomic group, and treatments lack a scientific base and instead are frequently dependent on empirical knowledge. Pharmacokinetic studies are the first step to determining therapeutic protocols that are safe and effective. The available bibliography shows that a majority of the mycoses recorded in cartilaginous fish are severe, aggravated by the fact that the antifungal treatments administered, following the guidelines used for teleost species, are ineffective in elasmobranchs. Azoles appear to be a promising group of antifungals for use in treating systemic mycoses in sharks and rays. Conclusions: Based on the findings of this review, it is essential to investigate the pharmacokinetics of the different antifungals in these species in order to provide therapeutic options for fungal infections in cartilaginous fish. [ABSTRACT FROM AUTHOR]